What Causes Diabetic Retinopathy: Prevention & Treatment

07/15/2022 | 7 min. read

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Want to hear an alarming statistic? By the year 2050, the number of Americans with diabetic retinopathy is expected to double, from 7.7 million to 14.6 million. Although diabetic retinopathy is an increasingly common cause of vision impairment and blindness, I want to assure you that it is not an inevitable complication of diabetes. 

Let’s take a look at what causes diabetic retinopathy, treatment options—and most importantly, how you can prevent it.

Causes of Diabetic Retinopathy

Diabetic retinopathy occurs when blood vessels in the retina, the light-sensitive tissue in the back of the eye, are damaged and fluids leak into the retina. The underlying cause of this damage is chronically elevated blood sugar—and the longer the duration of uncontrolled diabetes, the greater the likelihood of developing diabetic retinopathy. 

This and other vision complications can occur in people with both type 1 and type 2 diabetes, as well as gestational diabetes, which develops during pregnancy. Specific factors that further increase your risk of developing diabetic retinopathy include: 

  • Longer duration of diabetes
  • Poor control of blood sugar
  • High blood pressure
  • Elevated cholesterol
  • Pregnancy
  • Tobacco use
  • African American, Hispanic, or Native American heritage

What Are the Symptoms of Diabetic Retinopathy?

In the early stages of diabetic retinopathy, there are usually no symptoms. As the condition advances, the following symptoms may become evident:

  • “Floating” spots
  • Changes in vision
  • Blurry vision
  • Impaired color vision
  • Dark or empty areas in your vision
  • Loss of vision

Roughly 40%–45% of Americans diagnosed with diabetes have some degree of diabetic retinopathy, yet because of the lack of early symptoms, only about half are aware of it. So, it is very important for anyone with diabetes to get comprehensive dilated eye exams annually.

What Are the Four Stages of Diabetic Retinopathy?

Diabetic retinopathy can progress through four stages, ranging from mild to advanced:

  1. Nonproliferative retinopathy: This is the earliest and mildest stage. It is characterized by microaneurysms, tiny balloon-like swellings in the blood vessels that have the potential to leak fluids into the retina.
  2. Moderate nonproliferative retinopathy: During this stage, the blood vessels that nourish the retina may swell, distort, and lose their ability to transport blood.
  3. Severe nonproliferative retinopathy: As the disease progresses, more vessels become blocked, disrupting the delivery of blood, oxygen, and nutrients to the retina.
  4. Proliferative diabetic retinopathy: The most advanced stage is marked by the growth of abnormal blood vessels in the retina and the vitreous, the gel-like fluid that fills the back of the eye. These new vessels are fragile and may leak blood in the vitreous, clouding vision. They may also pull on the retina, leading to retinal detachment and vision loss.

Now you can see the importance of getting a jump on diabetic retinopathy before it progresses to more advanced stages—or, better yet, preventing it altogether.

Preventing & Slowing Diabetic Retinopathy

The most important thing you can do to reduce your risk of diabetic retinopathy and slow its progression is to control your diabetes. Although diabetes drugs are sometimes necessary to achieve optimal blood sugar levels, lifestyle is extremely important. Weight loss, exercise, and a healthy, low-glycemic diet are effective therapies for treating—and in some cases, reversing—diabetes. 

Lifestyle changes also enhance overall health and help lower blood pressure and cholesterol levels, which are additional risk factors for diabetic retinopathy.

I also recommend a good nutritional supplement program, with a focus on natural ingredients that support normal blood sugar levels, as well as those specifically targeting various aspects of eye health. 

Best Supplements for Diabetic Retinopathy 

  • Berberine: Berberine is the most effective natural compound for lowering blood sugar. In clinical trials involving patients with newly diagnosed type 2 diabetes, berberine reduced blood sugar as effectively as metformin, a popular diabetes medication. Recent animal studies suggest that berberine’s ability to suppress inflammation and oxidative stress also protects against diabetic retinopathy. The suggested dosage of berberine is 500 mg three times a day.
  • Lutein and zeaxanthin: Lutein and zeaxanthin are naturally occurring carotenoids that are highly concentrated in the retina and especially in the macula, a small area in the retina responsible for central vision. Although most of the research on these carotenoids involves macular degeneration, numerous studies also reveal broader benefits for eye health. Aim for 20–40 mg of lutein and 4–8 of zeaxanthin mg daily.
  • Pycnogenol: Pycnogenol is a versatile supplement obtained from French maritime pine bark. An exceptionally potent antioxidant, it protects the blood vessels and capillaries from free radical damage and improves blood flow. In a clinical trial involving patients with early diabetic retinopathy, taking 150 mg of Pycnogenol daily for three months enhanced retinal blood circulation, reduced fluid buildup in the eye, and improved visual acuity. The suggested dose of Pycnogenol is 150 mg per day. 
  • Multivitamins: High levels of blood sugar increase urination, resulting in the loss of critical nutrients. A good daily multivitamin, with high doses of antioxidants, B-vitamins, and minerals, is essential to help replenish protective nutrients. Make sure your multi has at least 500 mg of magnesium. Studies have found that people with the lowest levels of this important mineral are the most likely to develop severe diabetic retinopathy. Deficiencies in zinc and vitamins A, C, D, and E have also been implicated in degenerative eye disorders. 

Diabetic Retinopathy Treatment Options

What if you have already been diagnosed with more advanced diabetic retinopathy? Although it’s best to tackle this condition early on, there are treatments, even for stage 4 proliferative diabetic retinopathy.  

The most common treatments for proliferative retinopathy are injections of drugs that slow the growth of abnormal blood vessels, plus laser surgery to shrink blood vessels and stop leakage. There is also a surgical procedure, called vitrectomy, that removes blood from the vitreous and scar tissue near the retina. 

Two alternative therapies have been used to treat degenerative eye diseases. Although conventional ophthalmologists may not be familiar with them, they have been demonstrated to help slow the progression of diabetic retinopathy and are worth looking into. 

  • Hyperbaric oxygen therapy (HBOT), which involves breathing 100% oxygen in a specialized pressurized chamber, delivers massive amounts of oxygen to tissues throughout the body, including areas where blood supply is limited. HBOT has been shown in clinical trials to slow and stabilize the progression of diabetic retinopathy. 
  • Enhanced External Counterpulsation (EECP) dramatically increases blood flow and enhances the integrity and function of the blood vessels. Best known as a noninvasive treatment for coronary artery disease, it also slows the progression of diabetes-related retinopathy and neuropathy. 

I also want to remind you that it is never too late to make lifestyle changes and adopt a supplement program, as described above, for blood sugar control, vision support, and nutrient optimization. 

Diabetic Retinopathy Recap

Don’t let diabetes rob you of your vision. Because early detection and timely treatment give you the best chances of stopping diabetic retinopathy in its tracks, see your eye doctor for a comprehensive eye exam once a year.

Also, pay special attention to your blood sugar levels. Even if you require diabetes medications, a healthy diet, exercise, and weight loss help with blood sugar control and reduce your risk of developing retinopathy and other diabetic complications. Go the extra mile and start a comprehensive nutritional supplement program with proven nutrients for lowering blood sugar and enhancing vision health. 

We are truly facing an epidemic of diabetes and its many complications. Don’t be a statistic. Take charge of your health today. 

Dr. Julian Whitaker

Meet Dr. Julian Whitaker

For more than 30 years, Dr. Julian Whitaker has helped people regain their health with a combination of therapeutic lifestyle changes, targeted nutritional support, and other cutting-edge natural therapies. He is widely known for treating diabetes, but also routinely treats heart disease and other degenerative diseases.

More About Dr. Julian Whitaker